BVA9500712 DOCKET NO. 93-06 966 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Reno, Nevada THE ISSUE Entitlement to service connection for aseptic spinal meningitis. REPRESENTATION Appellant represented by: AMVETS WITNESS AT HEARING ON APPEAL Appellant and wife ATTORNEY FOR THE BOARD C.A. Skow, Associate Counsel INTRODUCTION The appellant served on active duty from October 1961 to September 1965 and October 1968 to November 1975. This matter came before the Board of Veterans' Appeals (the Board) on appeal from a February 1992 rating decision of the Reno, Nevada, Department of Veterans Affairs Regional Office (VARO). CONTENTION OF APPELLANT ON APPEAL The appellant contends that he suffers from aseptic spinal meningitis and that his low back pain during service was an early manifestation of this disorder. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the appellant has not met the initial burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim to service connection for aseptic spinal meningitis is well grounded. FINDINGS OF FACT 1. The appellant served on active duty from October 1961 to September 1965 and October 1968 to November 1975. 2. Service medical records dated in 1974 and 1975 show complaints of low back pain, a stiff back and neck, headaches, and swelling of the feet and hands which were medically related to renal colic and a past history of having passed a kidney stone. These records were wholly negative for the presence of aseptic spinal meningitis or significant pathology related thereto. 3. VA inpatient treatment reports dated in July and August 1989 reflect that the appellant was evaluated for possible aseptic spinal meningitis and other conditions after the appellant was admitted for complaints of low back pain, headaches, and intermittent temporary paralysis with falling down episodes. 4. Aseptic spinal meningitis was reported by history only; VA outpatient and inpatient treatment reports dated between June 1986 and June 1992 do not reflect a confirmed diagnosis of aseptic spinal meningitis. 5. The incurrence of aseptic spinal meningitis during service is inherently incredible. CONCLUSION OF LAW The appellant has not submitted evidence of a well grounded claim for service connection for aseptic spinal meningitis. 38 U.S.C.A. §§ 1101, 1110, 5107 (West 1991); 38 C.F.R. § 3.303 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION The threshold question to be answered at the outset of the analysis of any case is whether the appellant's claim is well grounded; that is, whether it is plausible, meritorious on its own, or otherwise capable of substantiation. Murphy v. Derwinski, 1 Vet.App. 78 (1990). If a particular claim is not well grounded, then the appeal fails and there is no further duty to assist in developing facts pertinent to the claim since such development would be futile. 38 U.S.C.A § 5107(a) (West 1991). For service-connection to be granted, it is required that the facts, as shown by the evidence, establish that a particular injury or disease resulting in chronic disability was incurred in service, or, if pre-existing service, was aggravated therein. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1993). An appellant has, by statute, the duty to submit evidence that a claim is well grounded. 38 U.S.C.A. 5107(a). Where such evidence is not submitted, the claim is not well grounded, and the initial burden placed on the appellant is not met. See Tirpak v. Derwinski, 2 Vet. App. 609 (1992). Evidentiary assertions by the appellant must be accepted as true for the purposes of determining whether a claim is well grounded, except where the evidentiary assertion is inherently incredible. See King v. Brown, 5 Vet.App. (1993). In this case, the appellant's evidentiary assertions as to the claim of onset of his aseptic spinal meningitis during service is inherently incredible when viewed in the context of the total record. In September 1991, the appellant filed for service connection for aseptic spinal meningitis including a low back condition, and claimed that the onset of this disease was in service. The evidence before the Board includes service medical records, VA outpatient treatment reports dated July 1977, statements of the appellant and his wife dated in February 1992, the sworn testimony of the appellant and his wife in July 1992, and VA outpatient and inpatient treatment reports dated June 1989 to June 1992. The service medical records reflect that the appellant complained of low back pain, a stiff back and neck, headaches, and swelling of the feet and hands in 1974 and 1975. At this time, his complaints were medically attributed to renal colic and a past history of having passed a kidney stone. There is no diagnosis of aseptic spinal meningitis or a suggestion of the presence of this disorder in the appellant's service medical records. In July 1977, the appellant filed for service connection for "low back pain and no control of legs." VA outpatient treatment reports dated in July 1977 reflect that the appellant was seen for complaints of pain in his low back, left hip, and legs. He indicated that his left hand and forearm become numb, and that he had difficulty holding things. He further indicated that this problem had persisted since 1972, and that he had an episode of temporary paralysis in 1975 (also reported as an inability to walk because of back pain). The appellant reported that his current complaints had persisted over the past five weeks. Clinical findings indicated a flattening of the lumbar lordotic curve, and the range of motion was noted as 100 degrees on flexion, 20 degrees on extension with the sensation that he was about to fall. Clinical findings reflect that reflexes were hyperactive bilaterally, sensation was diminished along lower left leg, and straight leg raises were negative bilaterally. The appellant's pulse, temperature, and blood pressure were within normal limits. The appellant was diagnosed with questionable discogenic disease and renal pathology. An x-ray study showed the spine to be within normal limits. The appellant was assessed with possible muscular sclerosis or rheumatoid arthritis. The appellant was scheduled for a VA examination in October 1977. However, the appellant failed to report for the scheduled appointment without explanation. Accordingly, VARO denied the appellant's claim. In February 1992, the appellant and his wife submitted statements in support of the claim. The substance of the statements reflect essentially the same information as that given at a personal hearing provided at the request of the appellant in July 1992. At the July 1992 personal hearing conducted at VARO, the appellant and his wife testified that the appellant has aseptic spinal meningitis productive of low back pain with headaches and intermittent temporary paralysis which had its onset during service approximately 15 years earlier. The appellant indicated that he was diagnosed with aseptic spinal meningitis in roughly 1989 and had been under treatment for the past four years. He argued that his back pain, headaches, and paralysis were attributable to aseptic spinal meningitis, and that the condition is untreatable because "its in a closed system with the brain stem and spinal cord and it can lay dormant for periods of time." He indicated that he has not experienced episodes of paralysis since his treatment for aseptic spinal meningitis. He further indicated that he was not a drinker, and that his history of falling down episodes are not attributable to drinking alcohol, but rather his aseptic spinal meningitis. The appellant reported that, at the time he was diagnosed with aseptic spinal meningitis, his brain was swollen. He noted that previous VA examinations had failed to notice the presence of a swollen brain, and these examinations instead related the appellant's complaints to a musculoskeletal or neurological defect. The appellant and his representative requested a VA medical examination. At the request of VARO, VA outpatient and inpatient treatment reports dated from June 1989 to June 1992 were submitted in support of the appellant's claim for service connection for aseptic spinal meningitis. VA inpatient treatment reports dated in June 1989 reflect treatment for hypertension and migraine headaches. VA inpatient treatment reports dated in July and August 1989 reflect that the appellant was admitted for complaints of headaches with pain starting at neck and radiating up behind temples to eyebrows, along with muscular weakness, sensory loss, and numbness starting at the right foot and progressing up the right side of the appellant's body. The appellant was evaluated for possible aseptic spinal meningitis and acquired immune deficiency syndrome. Lab results indicated that no acid fast bacillus or white blood cells were found. A bacteriological culture study revealed a rare streptococcus viridans group. The pathological report indicated that the cerebrospinal fluid cytosine preparation showed few lymphocytes, and that no neoplastic cells were identified. By history the appellant reports having had aseptic spinal meningitis in 1989. On self-referred psychiatric examination in July 1989 the appellant reported anxiety over his claimed "spinal virus," and the examiner later opined that the appellant "seemed to be a questionable historian with complaints of memory problems." There is no confirmed diagnosis for aseptic spinal meningitis in VA treatment reports dated in 1989 and 1990. Records dated between 1991 and 1992 reflect psychiatric, hypertensive, and genitourinary treatment, and are similarly wholly negative for either a diagnosis or findings related to aseptic spinal meningitis. Analysis The Board finds that there is no objective medical evidence to support the presence of aseptic spinal meningitis, or a relationship between the appellant's complaints of back pain, headaches, and intermittent temporary paralysis in 1989 and his period of service. The first suggestion of possible aseptic spinal meningitis was on VA inpatient treatment reports dated in July and August 1989. However, there is no indication that the appellant tested positive for aseptic spinal meningitis. References to aseptic spinal meningitis in the VA treatment reports dated between June 1989 and June 1992 reflect mostly a medical history by the appellant for the presence of aseptic spinal meningitis. The Board has considered the appellant's statements with respect to the presence of aseptic spinal meningitis, and a relationship between his claimed aseptic spinal meningitis and his period of service. However, we note that he lacks the medical expertise to enter a judgment regarding the existence of aseptic spinal meningitis or a medical relationship between the claimed aseptic spinal meningitis and any in-service onset. The Board may not accept unsupported lay speculation with regard to medical issues. See Espiritu v. Derwinski, 2 Vet.App. 482 (1992). Even were there a confirmed diagnosis of aseptic spinal meningitis in the VA treatment reports dated between June 1989 and June 1992, approximately 15 years after discharge, or in VA outpatient treatment reports dated in July 1977, a diagnosis of aseptic spinal meningitis alone would not establish a relationship between the appellant's disease and his period of service. To establish service-connection there needs to be a showing that the disability for which service-connection is sought is in some way related to service. Absent objective evidence of medical causality related to service, the claim is not well grounded. See Grivois v. Brown, 6 Vet.App. 136 (1994). Furthermore, lay assertions of medical causation cannot constitute evidence to render a claim well grounded. Grottveit v. Brown, 5 Vet.App. 91, 93 (1993). Where there is no medical evidence of the claimed disorder during service, or where there is no medical evidence linking the claimed disorder to service or an in-service event, the claim is not well grounded. See Fields v. Derwinski, 90-933 (U.S. Vet. App. Dec. 2, 1991). Accordingly, in view of the above, the undersigned concludes that evidence sufficient to establish that the claim to service connection for aseptic spinal meningitis is well grounded has not been presented. ORDER Having found the claim not well grounded, the appeal of service- connection for aseptic spinal meningitis is dismissed and the VARO rating decision of February 1992 from which this appeal arose is vacated. KENNETH R. ANDREWS, JR. Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.